A new drug combination could treat melanomas that resist therapy with a single drug, suggests research that appeared in Cancer Discovery on melanoma cells grown in the laboratory. The researchers tested melanoma cells that had BRAF mutations and resisted treatment with the BRAF inhibitor vemurafenib, and that had NRAS mutations, which resist many treatments. The most effective combination treatment was statins, which are commonly used to treat high cholesterol, but can also kill melanoma cells, and drugs that inhibit proteins called cyclin-dependent kinases, which are involved in cell division.

Despite promising results from small trials, a large clinical trial found that combining sorafenib with chemotherapy was no better than chemotherapy alone for melanoma patients. Sorafenib is FDA-approved for kidney and liver cancer that targets tumors by inhibiting the new blood vessels that help them grow and spread. However, this Journal of Clinical Oncology study also showed that the carboplatin/paclitaxel chemotherapy was surprisingly effective. This chemotherapy combination is now listed as a standard melanoma treatment by the National Comprehensive Cancer Network guidelines.

The experimental drug PV-10, which is injected directly into melanoma tumors, may work partly by boosting the immune system. To find out, researchers are launching a clinical trial to see if patients treated with PV-10 have immune biomarkers in their tumors and blood. The study will enroll up to 15 patients.

A JAMA Surgery study clarified when melanoma is likely to return in people determined to be cancer-free by sentinel lymph node biopsy. The researchers found that melanoma recurred in 16% of 515 such patients and that 4% of them had tumors in the lymph nodes that had been tested. Recurrence was more likely when the initial tumors were on the head or neck and were deeper (2.7 vs. 1.8 mm). Recurrence was less likely in women and in people who were younger when first diagnosed.

A genetic abnormality may help predict which melanomas in the eye are unlikely to spread, according to a study in Nature Genetics. The researchers found that nearly 20% of 102 people with eye melanomas had a mutation in a gene called SF3B1. These people were usually younger when diagnosed and their tumors were less likely to spread and become deadly.

Biotech company Genentech has added a MEK inhibitor to a phase III trial of vemurafenib, an FDA-approved BRAF inhibitor. MEK inhibitors have been shown to counteract resistance to BRAF inhibitors. The experimental MEK inhibitor is called GDC-0973, and is also known as XL-518 or RG7421. Vemurafenib (Zelboraf®) targets melanomas with BRAF V600 mutations, which are found in about half of these aggressive skin cancers. Genentech is part of the Roche Group; the two companies are conducting this combination treatment trial jointly.

New research in Nature shows that the immune system can control tumors permanently without destroying cells. The researchers treated cancers with two proteins that activate the immune system (interferon-g and tumor necrosis factor) and found that the combination kept tumors from growing by making the cells dormant. This work could ultimately lead to cancer treatments that are both effective and free of side effects, suggesting that we shift from the “war on cancer” strategy of killing tumor cells to focus instead on restoring the body’s innate ability to arrest tumor development.